title: Effect of mode of delivery on macronutrient content of breast milk.
abstract: OBJECTIVE
  To determine the effect of delivery type on macronutrient content of colostral milk.
  
  
  METHODS
  The study was conducted at Zekai Tahir Burak Maternity Teaching Hospital. Colostral milk samples from term lactating mothers who gave birth by vaginal or cesarean delivery (CD) were obtained on the 2nd postpartum day. Milk protein, fat, carbohydrate (CHO) and energy levels were measured by using a mid-infrared human milk analyzer.
  
  
  RESULTS
  A total of 204 term lactating mothers were recruited to the study; 111 mothers gave birth by vaginal route and 93 mothers by CD. Protein levels were statistically lower in colostral milk of mothers after CD compared to mothers who delivered vaginally (median 2.4 (range 0.3-6.4) g/dl versus 3 (0.5-6.3) g/dl, respectively; p = 0.036). Colostral fat, CHO and energy levels were similar between groups. In linear regression analysis, CD and maternal age were independently associated with lower protein content in colostrum.
  
  
  CONCLUSIONS
  Vaginal delivery is associated with higher colostrum protein content. Hormonal activity induced by labor pain and uterine contractions might account for the alterations in the protein composition of human milk to facilitate optimal development of important physiologic functions in newborns.
authors.affiliation: Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital , Ankara , Turkey and.
authors.forename: Evrim Alyamac
authors.initials: EA
authors.lastname: Dizdar
authors.forename: Fatma Nur
authors.initials: FN
authors.lastname: Sari
authors.forename: Halil
authors.initials: H
authors.lastname: Degirmencioglu
authors.forename: Fuat Emre
authors.initials: FE
authors.lastname: Canpolat
authors.forename: Serife Suna
authors.initials: SS
authors.lastname: Oguz
authors.forename: Nurdan
authors.initials: N
authors.lastname: Uras
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D000293:Adolescent; D000328:Adult; D002241:Carbohydrates / Q000032:analysis*; D003126:Colostrum / Q000737:chemistry; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation / Q000378:metabolism; D008055:Lipids / Q000032:analysis*; D008894:Milk Proteins / Q000032:analysis* / Q000378:metabolism; D008895:Milk, Human / Q000737:chemistry* / Q000378:metabolism; D011247:Pregnancy; D055815:Young Adult
chemical_list: D002241:Carbohydrates; D008055:Lipids; D008894:Milk Proteins
keywords: Breast milk; colostrum; delivery mode; milk composition